Hypertension (central and/or pulmonary) can be the primary cause of cardiac remodeling leading to heart failure (HF). Yet even in circumstances where the primary etiology of HF is in processes intrinsic to the heart, remodeling of the pump and its electromechanical properties will alter the pressures and flows in the cardiovascular system. So we are reminded that comprehensive understanding of complex cardiovascular disease requires the ability to look at (and probe) the system as a whole.